Does fair play reduce concussions? A prospective, comparative analysis of competitive youth hockey tournaments

Abstract

Background/aimTo determine if Boys Bantam and Peewee and Girls U14 sustain fewer concussions, head hits, ‘other injuries’ and penalties in hockey tournaments governed by intensified fair play (IFP) than non-intensified fair play (NIFP).MethodsA prospective comparison of IFP, a behaviour modification programme that promotes sportsmanship, versus control (non-intensified, NIFP) effects on numbers of diagnosed concussions, head hits without diagnosed concussion (HHWDC), ‘other injuries’, number of penalties and fair play points (FPPs). 1514 players, ages 11–14 years, in 6 IFP (N=950) and 5 NIFP (N=564) tournaments were studied.ResultsTwo diagnosed concussions, four HHWDC, and six ‘other injuries’ occurred in IFP tournaments compared to one concussion, eight HHWDC and five ‘other injuries’ in NIFP. There were significantly fewer HHWDC in IFP than NIFP (p=0.018). However, diagnosed concussions, ‘other injuries’, penalties and FPPs did not differ significantly between conditions. In IFP, a minority of teams forfeited the majority of FPPs. Most diagnosed concussions, HHWDC, and other injuries occurred to Bantam B players and usually in penalised teams that forfeited their FPPs.ConclusionsIn response to significant differences in HHWDC between IFP and NIFP tournaments, the following considerations are encouraged: mandatory implementation of fair play in regular season and tournaments, empowering tournament directors to not accept heavily penalised teams, and introducing ‘no body checking’ in Bantam.

What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review

“…Roberts et al 67 and Smith et al 68 demonstrated no difference in concussion risk with or without fair play rules in tournament play. However, Smith et al 68 demonstrated fewer non-injurious head contacts with ‘intensified’ fair play compared with ‘non-intensified’ fair play rules.…”

Primary prevention of contact sports-related concussions in amateur athletes: a systematic review from the Eastern Association for the Surgery of Trauma

“…Krolikowski et al 54 found that a policy of zero tolerance for head contact did not significantly reduce the risk of concussion in youth hockey. Smith et al 55 found that Fair Play systems, which incorporate sportsmanship and penalties into youth hockey game results, did not decrease the incidence of concussion.…”

A History of Concussions Is Associated With Symptoms of Common Mental Disorders in Former Male Professional Athletes Across a Range of Sports

“…Nevertheless, the actual policy related to concussions in professional football remains questioned and should be improved to protect the sustainable health of footballers. In ice hockey, the rule change related to eliminating checking to the head and banning hard plastic elbow pads has been proposed to prevent head injuries and protect players' health [34].…”